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Trump to House Republicans: Time to put up or shut up on Obamacare repeal

President Trump headed to Capitol Hill to make a personal pitch to Republicans on the bill to repeal Obamacare, making clear to them how important it is they stay united to pass the legislation and keep a key campaign promise of his and also of theirs.

Trump to House Republicans: Time to put up or shut up on Obamacare repeal

President Donald Trump was on Capitol Hill Tuesday, warning House Republicans they could lose their seats in next year's midterm elections if they failed to back the GOP health care overhaul and fulfill a long-promised goal to undo 'Obamacare.' (March 21)
AP

President Trump and Health and Human Services Secretary Tom Price walk to a meeting with House Republicans on the American Health Care Act on March 21, 2017.(Photo: Shawn Thew, European Pressphoto Agency)

WASHINGTON — President Trump headed to Capitol Hill on Tuesday to make a personal pitch to Republicans on the bill to repeal Obamacare, making clear to them how important it is they stay united to pass the legislation and keep a key campaign promise of his and also of theirs.

"The president of the United States came to us and said, 'We made a promise to the American people and we need to keep our promises,' " said House Speaker Paul Ryan, R-Wis. "The president was very clear and he laid it on the line for us."

Ryan said Trump did "what he does best — and that is to close the deal."

"The president just came here and knocked the ball out of the park," he said.

The personal entreaties from the president come as Republicans on Monday night released a modified version of the legislation seeking to win over more conservative votes. Under those changes, states could require able-bodied Medicaid recipients without dependents to work beginning in October. States also could receive Medicaid funding as a lump sum instead of a per capita allotment. The revised bill also would repeal taxes on the wealthy, the insurance industry and others in 2017 instead of 2018.

House leaders are planning to bring the measure up for a vote on Thursday, the seventh anniversary of the Affordable Care Act.

As he headed inside the Capitol, Trump gave a thumbs-up, and when asked whether he thought he would have enough votes to pass the bill, he said, "I think so." He emerged with the same optimistic tone, telling reporters, "I think we're going to get a winner vote."

"We're going to have a real winner. It was a great meeting. They're terrific people," Trump said. "They want a tremendous health care plan, which we have. There are going to be adjustments made. I think we'll see the votes on Thursday."

Not everyone was convinced, however. Rep. Dave Brat, R-Va., a member of the conservative Freedom Caucus, said he still won't support the bill.

“We’ve got to get the prices down," he said, which under the current version doesn't happen until the third year after passage. Brat said many people are focusing on how many people will be covered, but he and other fiscal hawks are looking at premiums and other factors.

Ryan maintained that many other Freedom Caucus members will support the legislation. He said there are "huge conservative wins" in the bill, including massive tax cuts and anti-abortion provisions that members requested. The Freedom Caucus has opted not to take a position on the bill, allowing individual members to announce their stances.

Ryan said the choice for members comes down to: "Do you want to stay with the Obamacare status quo?"

Speaker Paul Ryan addresses the media after a meeting between GOP lawmakers and President Trump on March 21, 2017.(Photo: Mark Wilson, Getty Images)

However, Dan Holler, the vice president of the conservative Heritage Action for America, said the group will continue to urge lawmakers to vote against the bill unless more Obamacare regulations are repealed in the legislation. The conservative Club for Growth also announced Tuesday that it is launching a $500,000 digital ad campaign in the congressional districts of 10 House members, calling on them to reject "RyanCare."

"The RyanCare bill fails to keep President Trump’s promises of interstate competition and health insurance deregulation," saidClub for Growth President David McIntosh. "Republicans promised a bill that would stop Obamacare’s taxes and mandates, and replace them with free-market reforms that will increase health insurance competition and drive down costs. RyanCare fails on those counts."

Ryan said some of the things that Republicans are seeking, such as allowing consumers to buy insurance across state lines, cannot be included in the bill because they would violate the budget rules that allow Republicans to push the legislation through the Senate with a simple majority of 51 votes. There are 52 Republicans in the Senate. However, GOP leaders said those issues will be taken up in separate legislation, which would require Democratic support in the Senate.

The effort is the first legislative test for Trump — and a heavy lift. Even if the bill passes the House, getting it through the Senate will be difficult.

The bill as it stands would eliminate the mandate that individuals buy health insurance or face a tax penalty. Instead, they could pay a fine if uninsured for longer than 90 days. It would also change tax credits for low-come Americans to buy insurance and repeal the law's tax increases on the wealthy, insurance companies, drugmakers and others. It would still allow adult children to stay on their parents' plans until age 26 and prohibit insurance companies from denying coverage based on pre-existing conditions.

The difficulty for Trump and House GOP leaders is that the changes they are making to appease conservatives may make the bill harder to pass in the Senate, where moderate Republicans are worried about the impact of Medicaid cuts on low-income people, seniors in nursing homes, and Americans who need treatment for opioid addiction.

Ryan said House leaders are trying to be careful.

"We don't want to put something in the bill that the Senate is telling us is fatal to the bill," he said at a news conference Tuesday.

If the bill passes the House, it will undoubtedly be amended in the Senate. Senate Republicans are looking to make some significant changes, including expanding subsidies for older, low-income Americans, who would end up paying much more under the House legislation than they do under Obamacare.

If the Senate passes a bill, negotiators from the House and Senate will have to try to reach consensus on final legislation.

It was unclear until recent days just how much skin the new president had in the game, despite the repeal of Obamacare being a central campaign promise. News reports last week suggested he might not take full ownership of the issue, but he has since taken it on, including at a rally in Louisville, Ky., on Monday night.

“This is our long-awaited chance to finally get rid of Obamacare,” Trump exhorted the crowd.

President Trump takes the stage at a rally at the Kentucky Exposition Center in Louisville, Ky., on March 20, 2017.(Photo: Andrew Harnik, AP)

He did appear to cast it at times more as something that just needs to be done in order to get to other legislative priorities, such as reducing taxes, “one of my truly favorite things,” he said.

Brat said Trump hit the same theme during Tuesday's meeting on Capitol Hill. “He wants to pass this because we all want to move onto tax reform,” he said. Brat said he isn't worried about Trump turning his Twitter wrath against him and other Freedom Caucus members who are up for reelection in 2018 if they end up sinking the bill.

“We can defend our position intellectually, and that’s all that matters,” he said.

Democrats, meanwhile, continued blasting the legislation, including the modified version. House Minority Leader Nancy Pelosi, D-Calif., said “Republicans are trying to put lipstick on a pig."

"No matter how the Republicans try to dress it up, TrumpCare is a plan to push 24 million people off their health coverage and force Americans to pay more for less health care," she said.

"Republicans are desperately trying to save this bill," he said, but added that the changes "amount to a fresh coat of paint on an old jalopy."

White House Press Secretary Sean Spicer said Trump will continue meeting with lawmakers in the coming days, and he reiterated that the legislation is just one part of the health care overhaul envisioned. Spicer said Tom Price, Secretary of Health and Human Services, also will make administrative changes, and he reiterated that later bills would make further changes, including allowing the sale of health insurance across state lines.

"I think the president continues to engage members; he will continue to do that through Thursday," Spicer said. "We feel very good going into the final stretch."

In this Jan. 30, 2018, file photo, President Trump gestures as he delivers his first State of the Union address in the House chamber of the U.S. Capitol to a joint session of Congress in Washington, as Vice President Mike Pence and House Speaker Paul Ryan applaud. Win McNamee, AP

President Trump sings the National Anthem at Mercedes-Benz Stadium in Atlanta on January 8, 2018.
Trump is attending the College Football Playoff National Championship between the University of Georgia Bulldogs and the University of Alabama Crimson Tide. Jim Watson, AFP/Getty Images

President Trump waves as he departs after addressing the media at Camp David on Jan. 6, 2018 in Thurmont, Maryland. President Trump met with staff, members of his Cabinet and Republican members of Congress to discuss the Republican legislative agenda for 2018. (Photo by Chris Kleponis-Pool/Getty Images) Pool

President Trump returns to the White House following a weekend trip with Republican leadership and members of his cabinet at Camp David, on Jan. 7, 2018 in Washington, D.C. (Photo by Kevin Dietsch-Pool/Getty Images) Pool, Getty Images

President Trump speaks with reporters as he arrives for a New Year's Eve gala at his Mar-a-Lago resort with first lady Melania Trump and their son Barron, Sunday, Dec. 31, 2017, in Palm Beach, Fla. (AP Photo/Evan Vucci) Evan Vucci, AP

President Trump and first lady Melania are escorted by Rev. James R. Harlan as they arrive for Christmas Eve service at the Church of Bethesda-by-the Sea, in West Palm Beach, Fla., Sunday, Dec. 24, 2017. (AP Photo/Carolyn Kaster) Carolyn Kaster, AP

President Trump and first lady Melania Trump speak on the phone with children as they track Santa Claus' movements with the North American Aerospace Defense Command (NORAD) Santa Tracker on Christmas Eve at the president's Mar-a-Lago estate in Palm Beach, Fla., Sunday, Dec. 24, 2017. (AP Photo/Carolyn Kaster) Carolyn Kaster, AP

President Trump and First Lady Melania Trump walk on the stage during the 95th annual National Christmas Tree Lighting ceremony at the Ellipse in President's Park near the White House in Washington, D.C. on Nov. 30, 2017. / AFP PHOTO / Jim Watson/AFP/Getty Images Jim Watson, AFP/Getty Images

In this Nov. 30, 2017, photo, President Trump holds first lady Melania Trump's hand as they walk back to the stage during the lighting ceremony for the 2017 National Christmas Tree on the Ellipse near the White House in Washington. (AP Photo/Manuel Balce Ceneta) Manuel Balce Ceneta, AP

U.S. President Donald Trump leaves the White House to visit troops at Walter Reed Bethesda Naval Medical Center Dec. 21, 2017 in Washington, D.C. Trump said he was visiting the injured military service members to wish them a merry Christmas. (Photo by Chip Somodevilla/Getty Images) Chip Somodevilla, Getty Images

President Trump holds up a bill after signing it in the Oval Office of the White House in Washington, D.C, on Dec. 22, 2017. Trump signed the tax bill, a continuing resolution to fund the government, and a missile defense bill before leaving to spend Christmas in Mar-a-Lago, Florida. Michael Reynolds, EPA-EFE

U.S. President Donald Trump (L) hosts members of the Native American code talkers during an event in the Oval Office of the White House, on Nov. 27, 2017 in Washington, D.C. Trump stated, "You were here long before any of us were here. Although we have a representative in Congress who they say was here a long time ago. They call her Pocahontas," in reference to his nickname for Sen. Elizabeth Warren. (Photo by Oliver Contreras-Pool/Getty Images) Pool, Getty Images

11-year-old Frank "FX" Giaccio gets a pat on the back from Trump while mowing the lawn in the Rose Garden of the White House on Sept. 15, 2017. Giaccio wrote a letter to Trump expressing admiration for Trump's business background and offered to mow the White House lawn. Win McNamee, Getty Images

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President Trump, Speaker Paul Ryan and other congressional Republicans celebrate in the Rose Garden of the White House following the House vote to repeal Obamacare on May 4, 2017. Mandel Ngan, AFP/Getty Images

Secretary of the Interior Ryan Zinke listens while Trump speaks before signing an executive order to review the Antiquities Act at the Department of the Interior on April 26, 2017. Brendan Smialowski, AFP/Getty Images

Trump prepares to award a Purple Heart to U.S. Army Sgt. 1st Class Alvaro Barrientos, with first lady Melania Trump, right, and Tammy Barrientos, second from right, at Walter Reed National Military Medical Center on April 22, 2017, in Bethesda, Md. Alex Brandon, AP

New England Patriots head coach Bill Belichick, President Trump, Patriots owner Robert Kraft and Patriots President Jonathan Kraft stand with Patriots players as Trump holds a team helmet at a ceremony honoring the Patriots as Super Bowl champions on the South Lawn at the White House on April 19, 2017. Geoff Burke, USA TODAY Sports

President Trump, flanked by Health and Human Services Secretary Tom Price and Vice President Pence, speaks about the health care overhaul bill on March 24, 2017, in the Oval Office. Pablo Martinez Monsivais, AP

Trump gets in the driver's seat of an 18-wheeler while meeting with truck drivers and trucking CEOs on the South Portico prior to their meeting to discuss health care at the White House on March 23, 2017. Jim Lo Scalzo, European Pressphoto Agency

Trump and German Chancellor Angela Merkel walk down the Cross Hall to enter the East Room for a joint press conference at the White House on March 17, 2017. Michael Reynolds, European Pressphoto Agency

Trump holds up a note and drawing depicting him that was created by the child of Greg Knox of Ohio during a meeting on health care in the Roosevelt Room on March 13, 2017. MIchael Reynolds, Pool, Getty Images

Trump walks with grandchildren Arabella Kushner and Joseph Kushner, holding a model of Marine One, across the South Lawn of the White House on March 3, 2017, before boarding Marine One helicopter for the short flight to nearby Andrews Air Force Base. Pablo Martinez Monsivais, AP

Trump reaches out to shake hands with Army Lt. Gen. H.R. McMaster at his Mar-a-Lago estate in Palm Beach, Fla., on Feb. 20, 2017, where Trump announced that McMaster will be the new national security adviser. Susan Walsh, AP

White House Chief of Staff Reince Priebus and Vice President Pence look on as Trump speaks briefly to reporters after greeting Harley Davidson executives on the South Lawn of the White House on Feb. 2, 2017. Drew Angerer, Getty Images

Trump reads from one of the executive orders he signed during a visit to the Department of Homeland Security with Vice President Mike Pence, Homeland Security Secretary John Kelly and other officials in Washington on Jan. 25, 2017. Chip Somodevilla, Pool/European Pressphoto Agency

President Trump holds a letter left for him by former president Barack Obama as Vice President Pence looks on before the swearing-in of the White House senior staff on Jan. 22, 2017. Mandel Ngan, AFP/Getty Images

Trump is joined by the congressional leadership and his family as he formally signs his cabinet nominations into law in the Presidents Room of the Senate on Jan. 20, 2017. J. Scott Applewhite, Pool Photo-USA TODAY Sports